Abstract
Video observation (VO) is an established tool for observing toothbrushing behaviour, however, it is a subjective method requiring thorough calibration and training, and the toothbrush position is not always clearly visible. As automated tracking of motions may overcome these disadvantages, the study aimed to compare observational data of habitual toothbrushing as well as of post-instruction toothbrushing obtained from motion tracking (MT) to observational data obtained from VO. One-hundred-three subjects (37.4±14.7 years) were included and brushed their teeth with a manual (MB; n = 51) or a powered toothbrush (PB; n = 52) while being simultaneously video-filmed and tracked. Forty-six subjects were then instructed how to brush their teeth systematically and were filmed/tracked for a second time. Videos were analysed with INTERACT (Mangold, Germany); parameters of interest were toothbrush position, brushing time, changes between areas (events) and the Toothbrushing Systematic Index (TSI). Overall, the median proportion (min; max) of identically classified toothbrush positions (both sextant/surface correct) in a brushing session was 87.8% (50.0; 96.9), which was slightly higher for MB compared to PB (90.3 (50.0; 96.9) vs 86.5 (63.7; 96.5) resp.; p = 0.005). The number of events obtained from MT was higher than from VO (p < 0.001) with a moderate to high correlation between them (MB: ρ = 0.52, p < 0.001; PB: ρ = 0.87; p < 0.001). After instruction, both methods revealed a significant increase of the TSI regardless of the toothbrush type (p < 0.001 each). Motion tracking is a suitable tool for observing toothbrushing behaviour, is able to measure improvements after instruction, and can be used with both manual and powered toothbrushes.
Highlights
Removing dental plaque in a sufficient and effective way is a prerequisite for maintaining oral health
As the tracking of motions (MT) during toothbrushing has not been systematically evaluated, the present study aims at comparing data and results from video observations (VO) to those from motion tracking
For all cases from the first part of the study the median proportion of matching areas from the two methods was 87.8%; 79.6% of the cases had 80% matches and 40.8% of the cases had 90% matches
Summary
Removing dental plaque in a sufficient and effective way is a prerequisite for maintaining oral health. Many studies have evaluated the efficacy of toothbrush types and toothbrushing techniques mainly using plaque or gingivitis indices as target parameter [1,2,3,4,5]. Though these parameters are of clinical relevance, they are surrogates with respect to the question how toothbrushing was performed. Getting insights into motion habits during toothbrushing, may help to improve instruction strategies. To this end, video observation (VO) is a method allowing for analysing
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